1053390914 NPI number — MATTHEW R LINDAMAN D.O.

Table of content: MATTHEW R LINDAMAN D.O. (NPI 1053390914)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053390914 NPI number — MATTHEW R LINDAMAN D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LINDAMAN
Provider First Name:
MATTHEW
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053390914
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/05/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5250 COMPETITION DR STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BETTENDORF
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52722-8837
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
563-322-0971
Provider Business Mailing Address Fax Number:
563-324-0615

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5250 COMPETITION DR STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BETTENDORF
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52722-8837
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
563-322-0971
Provider Business Practice Location Address Fax Number:
563-324-0615
Provider Enumeration Date:
01/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  3309 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207X00000X , with the licence number: 036102562 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1214528 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: IA01A7 . This is a "JOHN DEERE FAMILY" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: P00195719 . This is a "RR MEDICARE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: IA01A8 . This is a "JOHN DEERE FAMILY" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 35021 . This is a "MIDLANDS CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 37771 . This is a "WELLMARK" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 92233 . This is a "WELLMARK" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: IL01A9 . This is a "JOHN DEERE FAMILY" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 153910 . This is a "IA HEALTH SOLUTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: IA01A5 . This is a "JOHN DEERE FAMILY" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: IA01A6 . This is a "JOHN DEERE FAMILY" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 063409 . This is a "HEALTH ALLIANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 37770 . This is a "WELLMARK" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 8121085 . This is a "BCBS" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: IA01B1 . This is a "JOHN DEERE FAMILY" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




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